How Is Medicare Related To Workers Comp California?

Medicare is a secondary payer that covers all medical bills that are not paid by insurance. Most workers are covered by workers comp California as opposed to Medicare. Workers compensation covers for medical expenses for injuries that you get in your workplace.

The workers compensation insurance company can reimburse Medicare if at all Medicare did not cover all medical bills that were as a result of an industrial injury. You are entitled to medical benefits from workers compensation for as long as you need medical care. If you are not currently on Medicare you may be entitled to it later when workers compensation is still paying your treatment costs.

If at the Mandatory Settlement Conference you settled your case using Stipulation and Award you could use Medicare for any other treatment except for treatment that is being covered for by workers comp California. If your settlement was based on Compromise and Release then the workers compensation insurance is responsible for all your future medical care and Medicare will not cover any treatment. Medicare cannot pay bills that workers compensation has already paid for.

If you keep your future medical care open Medicare will have fewer bills to pay. Medicare looks out for any interests in their favor during settlement. This process begins with analyzing likely future medical costs of any injuries that are work related. Analysis is based on the medical costs of the previous two years and projections by your doctor. There are several companies which are specialized in analyzing future medical costs. It is normally the workers compensation insurance that pays one of these companies to create a Medicare Set Aside Analysis.

Workers compensation insurance looks out for the interest of Medicare to avoid being held responsible by Medicare. This same threat will usually force your attorney into a system that delays a Compromise and Release for close to six months up to a year. The problem with all these is that you will be the one needing medical care desperately and Medicare will not pay. Most attorneys recommend that you do not settle your future medical care by Compromise and Release.

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